The most recent ๐ฉ๐ฐ COVID-19 report from @SSI_dk was released earlier today ๐.
Let's take a look at some of the key numbers/graphs and provide some context for why I find the situation (and strategy) concerning ๐งต.
files.ssi.dk/covid19/tendensrapport/rapport/ugentlige-tendenser-covid19-andre-luftvejs-uge7-2022-5l9s
1/
First, incidence. As has already been discussed, the number of cases have increased steadily since the beginning of the year.
Note also the very high positivity rate as well - close to 40% (PCR) for week 6. Cases are not simply found "because ๐ฉ๐ฐ tests a lot".
2/
The same trend is reflected in hospitalizations, which are also going up - as already discussed.
ICUs remain stable or are decreasing.
Deaths are going up - a trend also observed in recent days with ~30-45 daily deaths.
3/
Here's a look just at deaths.
Green = "with" COVID-19 (increasing)
Magenta = "from" COVID-19 (increasing)
More about these in a bit.
4/
Here's another graph with deaths, classifying them into various categories of "from", "with", or "currently unclassified". Note, in recent weeks (as expected) - many still remain unclassified (arrow).
5/
Trying to classify hospitalizations or deaths into "with" or "from" is not a new problem (it's come up multiple times since the start of the pandemic).
Nor is it a problem specific to Denmark.
6/
Of course, because of highly effective vaccines (๐), we expect the ratio to shift towards more "with" cases.
Seems simple to correct then, right?
No. It's not.
Recent article on why this isn't simple.
washingtonpost.com/politics/2022/01/11/difference-between-being-hospital-with-covid-19/
7/
For example, if somebody with heart disease dies of a myocardial infarction three weeks after testing positive for COVID-19, what caused the person to die? A cancer patient four weeks after starting chemo? A transplant patient?
These issues compound and also cause delays.
8/
Back to the report. Denmark has very high vaccination and booster rates - which are *unquestionably* keeping cases/hospitalizations/deaths lower than they otherwise would be.
Booster rates remain flat though - and there are plans to cancel/pause the program shortly.
9/
Here's where one of the main issues of having 'rampant' cases start to become a big issue - an (entirely predictable) shift in age groups.
We're now seeing that effect in ๐ฉ๐ฐ - starts in the young, then moves to the elderly. We have seen this in *every* wave.
10/
This effect is important when we consider "from" vs "with" COVID-19, because we see that most of the "with" group is driven by younger people and the "from" group by the elderly.
Red = "from"
Blue/Green = "with"
11/
If we look at nursing homes we're seeing this effect especially clearly. Again, this is entirely predictable and expected when cases are (very) high.
More nursing homes having outbreaks.
More cases.
More deaths.
12/
As incidence remains high - because very little is being done to lower community transmission with no restrictions in place - we might expect cases to remain high for the foreseeable future, with a steady shift in age groups affected.
Wastewater signal is increasing.
13/
So looking at this report - and only focusing on population-based acute effects - I see several trends that concern me.
Are these acute consequences acceptable? For me, no, but politicians need to decide. Are we making decisions based on a realistic outlook? I'm not sure.
14/
Of course, there's a reason why I mention "acute" here - because all of this completely ignores potential long-term consequences of virtually everybody getting infected in a society - likely at least twice a year if no restrictions are in place.
15/
I have termed this "endemic delusion" - I'm worried that we're forgetting lessons over the last two years in a desperate attempt to "get back to normal" - a "normal" that unfortunately doesn't exist at the moment.
science.org/content/article/it-time-live-covid-19-some-scientists-warn-endemic-delusion
16/
US-centric, but very important writing from @gregggonsalves @nytimes on this topic as well:
nytimes.com/2022/02/17/opinion/aids-pandemic-covid.html
17/
We're also forgetting issues of "long" COVID-19 - which is significant. And, unfortunately, while there is *no* question that vaccination significantly lowers the risk of "long" COVID-19, it may still pose a very substantial problem.
Recent summary:
ukhsa.koha-ptfs.co.uk/cgi-bin/koha/opac-retrieve-file.pl?id=fe4f10cd3cd509fe045ad4f72ae0dfff
18/
And we're forgetting The Millions Of People Stuck In Pandemic Limbo @edyong209 ๐งต๐
twitter.com/edyong209/status/1493969707849953284?s=20&t=O5aZElHYawyD3VWgMBIEVw
19/
We're forgetting - or ignoring - that Omicron is milder, but not mild; that immunity wanes and new variants will emerge - but we don't know when, where, or how; and that access & equity REALLY matter.
twitter.com/K_G_Andersen/status/1492265606128627712?s=20&t=O5aZElHYawyD3VWgMBIEVw
20/
All of these things matter in ๐ฉ๐ฐ - my home country and where my family lives - but none of this is specific to ๐ฉ๐ฐ since almost all (western) countries are moving in the same direction.
I talked about that with @ASlavitt last week @inthebubblepod.
twitter.com/ScrippsRTI/status/1493652527081877505?s=20&t=7gYmRkaA1AV11qOXVYo93A
21/
Yes, we have been here before.
twitter.com/K_G_Andersen/status/1486747833382305799?s=20&t=i7w8HfgpSntxhWuN41pJ7w
22/
If we really want to ensure that we can get "back to normal" ASAP we need to science the shit out of this and keep innovating like there's no tomorrow.
Having long-term, realistic, data-driven, multi-pronged strategies will get us there. ๐๐ will not.
fin/